Скачать или смотреть HMP 28 Hyperbaric Oxygen in Skin Grafts and Flaps

#HyperbaricOxygenTherapy #HBO2 #SkinGrafts #SkinFlaps #WoundHealing #CompromisedTissue #RadiationInjury #Mastectomy #FlapSalvage #PlasticSurgery

This video deep dive explores Hyperbaric Oxygen Therapy (HBO2) as a powerful tool for helping compromised skin grafts and flaps survive and heal. Unlike normal healthy tissue healing, HBO2 is valuable in tricky scenarios where tissue has poor blood supply or previous damage, like from radiation.

The basic problem in compromised tissues is hypoxia (low oxygen), where levels drop significantly compared to healthy tissue. This low oxygen prevents fibroblasts, key cells for tissue repair, from producing collagen and building new capillaries. HBO2 addresses this by placing the patient in a chamber, increasing pressure, and having them breathe 100% oxygen. This dissolves a large amount of extra oxygen into the blood plasma, delivering it to starved areas and boosting oxygen levels dramatically. The influx of oxygen stimulates fibroblasts, collagen production, and new capillary growth (neovascularization).

Additional benefits of HBO2 include improving white blood cell function to fight infection, reducing swelling (edema), and potentially redirecting blood flow away from non-essential shunts to needed capillaries through vasoconstriction. Fibroblasts might even be stimulated by the cycling between low and high oxygen levels during treatments.

Animal studies provide a strong foundation, showing HBO2 significantly cuts down healing time, increases success rates for grafts and flaps (even compromised or irradiated ones), and promotes angiogenesis. Crucially, starting HBO2 early after surgery or suspecting poor flow leads to much better outcomes, with significant benefit seen within four hours in some studies. Both the pressure and high oxygen concentration are important.

Clinical evidence, while often built on animal data and experience for surgical flaps/grafts, is robust for uses like difficult diabetic foot ulcers and late radiation injury (e.g., osteoradionecrosis). Case reports highlight its potential in salvaging threatened mastectomy flaps. Studies suggest high survival rates for compromised tissues when using HBO2. It can also be a limb-saver in severe ischemia and improves survival in replanted digits/limbs/ears.

From a practical standpoint, HBO2 can be cost-effective by preventing expensive complications like flap/graft failure. Typical treatment involves daily sessions (90-120 mins) at 2.0-2.5 atmospheres absolute (ATA), tailored to the individual patient and their response. While not a universal cure, HBO2 offers significant, meaningful benefits for tissues struggling with oxygen deprivation.

This deep dive draws on sources including "Hyperbaric Medicine Practice" and various studies.